The Impact of a School-based WASH Intervention on Child Health and School Attendance in Addis Ababa, Ethiopia

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

7072 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-02

Study Completion Date

2022-08-10

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This study aims to assess the effects of school-based, comprehensive water, sanitation, and hygiene improvements on child health and educational outcomes in schools in Addis Ababa, Ethiopia. Eligible schools will be randomly allocated to intervention or control groups. Data on pupil absence and illness will be collected longitudinally from students in selected classrooms in each school over the course of one academic year (2021/2022). This study will also assess the effects of the intervention on kindergarten students through parent interviews.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

The Impact of Improved WASH in Schools on Absence, Diarrhea and Helminth Infection in Lao PDR

NCT02342860

Hygiene

COMPLETED NA

Spillover Effects of Water, Sanitation, and Hygiene Interventions on Child Health

NCT02396407

Helminthiasis Diarrhea Respiratory Infection

COMPLETED NA

Impact of Hand Washing and WASH Educational Intervention on Under-five Diarrheal Diseases

NCT02779010

Diarrhea

COMPLETED NA

Effects of Multiple Interventions on Under-Five Diarrhea

NCT07158632

Diarrheal Diseases

NOT_YET_RECRUITING NA

WASH Benefits Bangladesh

NCT01590095

Malnutrition Diarrhea Child Development

UNKNOWN NA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This study uses a cluster-randomised controlled trial design to evaluate the impact of the WASH in Schools for Everyone (WISE) programme. Project WISE, implemented by Splash, aims to improve child health and attendance by 1) improving WASH infrastructure, 2) promoting WASH behaviour change and 3) strengthening menstrual hygiene management (MHM) services targeting girls aged 10 and above, in public schools across Addis Ababa.

60 public schools from planned implementation groups that will receive the WISE intervention will be randomised: 30 schools will be allocated to the intervention group (to receive the WISE intervention during the 2021/2022 academic year) and 30 schools will be allocated to the control group (on a waitlist to receive the WISE intervention after study completion). Randomisation will be stratified by school size (number of students) and presence of a kindergarten. In each selected school, between two and four classes will be randomly selected from grades 2-8 - to obtain a sample size of approximately 100 students in total per school. Students in the selected classes will be enrolled at the start of the academic year (September 2021) and followed up with unannounced visits every 4-6 weeks until the end of the academic year (May 2022). Primary outcomes of pupil-reported illness and absence will be assessed during enrolment and at each follow-up visit. Secondary outcomes are restricted to subsets of students by age and gender, and will be assessed during the final follow-up visit. Students joining the class mid-way through the year will be enrolled in the study, and students who leave the class will be recorded.

Key outcomes of interest are longitudinal prevalence of absence and illness (diarrhoea and respiratory infection) over the course of the academic year, measured as cumulative number of days absent/with illness per 100 school days after adjustment for child- and school-specific covariates. Data collected in intervention schools prior to and/or during the active Splash intervention will not be included in the primary impact evaluation analysis. Sub-population analysis of evaluation outcomes in girls post-menarche will allow assessment of the gendered effects of the intervention. We will also monitor intervention fidelity and compliance, as well as cost-effectiveness of the intervention, through routine data collection with students and school staff.

40 public schools with a kindergarten will be enrolled to assess the impacts of the intervention among kindergarten students (20 intervention, 20 control). Schools enrolled in the intervention and control arms of the main study among older children that have a kindergarten will be also enrolled in the kindergarten evaluation. If there are fewer than 20 such schools in each arm, additional kindergarten schools will be randomised (estimated 10 additional schools per arm). In each selected school, 20 kindergarten students will be randomly selected for participation. Parents of selected students will be invited to participate in weekly telephone surveys over a four-week period in February/March 2022 in order to assess the longitudinal prevalence of illness and absence among kindergarteners.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Diarrhea Respiratory Tract Infections Absenteeism

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

WASH in Schools programme

Schools in the intervention group will receive the Splash WASH in Schools programme (Project WISE) during the study period (2021/2022 academic year), including sanitation, water storage and filtration, drinking water and handwashing stations, and hygiene and menstrual health education.

Group Type EXPERIMENTAL

Splash WASH in Schools programme (Project WISE)

Intervention Type OTHER

The Project WISE intervention includes:

WASH infrastructure

* Water storage tanks and water filtration systems
* Durable plastic drinking water and handwashing stations
* New/rehabilitated toilet facilities (gender-segregated, wheelchair-accessible, well-lit, ventilated, durable door and lock)

Behaviour change promotion

* Training of focal teachers to organise student 'hygiene club'
* Annual soap drive and soap restocking
* Behavioural 'nudges' (posters and mirrors at handwashing stations, colourful vests for hygiene clubs)

MHM services

* Toilets have water tap, bucket and waste bin
* Emergency menstrual hygiene products available at school
* Training of focal teachers to organise student 'gender club'
* Education on puberty and menstruation for all pupils above 10 and parent resource guide

Control

Schools in the control group will receive no intervention during the study period (2021/2022 academic year), but will be on a waitlist to receive the Project WISE intervention after the end of the study period (2022/2023 academic year or later).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Splash WASH in Schools programme (Project WISE)

The Project WISE intervention includes:

WASH infrastructure

* Water storage tanks and water filtration systems
* Durable plastic drinking water and handwashing stations
* New/rehabilitated toilet facilities (gender-segregated, wheelchair-accessible, well-lit, ventilated, durable door and lock)

Behaviour change promotion

* Training of focal teachers to organise student 'hygiene club'
* Annual soap drive and soap restocking
* Behavioural 'nudges' (posters and mirrors at handwashing stations, colourful vests for hygiene clubs)

MHM services

* Toilets have water tap, bucket and waste bin
* Emergency menstrual hygiene products available at school
* Training of focal teachers to organise student 'gender club'
* Education on puberty and menstruation for all pupils above 10 and parent resource guide

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* School is part of Splash Project WISE implementation groups
* School agrees to participate in the research

* Child is registered at a school that meets eligibility criteria and selected for the study
* Child is in grades 2-8
* Child's parents do not return the opt-out consent form
* Child provides assent to participate in the research

* School is part of Splash Project WISE implementation groups
* School has a kindergarten
* School agrees to participate in the research

* Child is registered at a school that meets eligibility criteria and selected for the study
* Child is in kindergarten
* Child's parent/guardian provides consent to participate in the research

Exclusion Criteria

* School has received a water, sanitation, or hygiene intervention in the three years prior to study activities
* School is kindergarten only
* School is secondary only (grades 9 and above, equivalent)
* School provides education to vulnerable population groups only

* Child is unable to provide assent for data collection
* Child is 17 or older
* Child does not meet age eligibility for specific data collection activities

Kindergarten evaluation (4-6 years)

* School has received a water, sanitation, or hygiene intervention in the three years prior to study activities
* School provides education to vulnerable population groups only

* Child is 7 or older

Minimum Eligible Age

4 Years

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No